{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GEORGES KAADO MOAWAD","gend":0,"add":"928 WINTHROPE DR","city":"VIRGINIA BEACH","state":"VA","zip":"23452-9998","dob":"1942-12-06","age":"","mstatus":"","insh":"20064198*01","cliId":"","pno":"786\/246-3654","cno":"786\/246-3654","email":"","ename":"","eno":"","pphy":"SINGSON, FLORISA S MD","ppno":"757\/518-8810","pcpadd":"STE B 4501 N WITCHDUCK RD","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":23455,"pcpcounty":"","pcpid":132034,"pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10.","M48.02","M48.07","M15.9","F32.9","E27.9","NO DATA","G47.33","M54.5","R56.9","H25.813","H40.043","R55.","R91.1","R00.2","M54.2","M54.16","M53.3","F41.8","Z68.24","H11.423","Z00.01","R42.","R53.1","R07.9","R00.1","M54.12","Z53.21","G25.81","M54.42","M54.41","M54.17","R29.898","R41.89","K27.9","Z12.5","M54.9","R29.6","Z87.828","G89.29","M48.061","H25.812","H90.6","H93.13","H61.23"],"date":["2021-05-18","2021-04-20","2021-04-20","2021-05-18","2021-05-18","2020-08-31","2020-08-31","2020-11-05","2021-04-20","2020-11-11","2021-07-07","2021-07-28","2020-07-23","2020-07-23","2020-08-14","2021-06-03","2021-09-07","2020-08-20","2021-01-26","2021-01-26","2021-07-28","2020-05-22","2020-08-11","2020-06-29","2020-06-29","2020-07-23","2020-11-17","2020-07-07","2020-11-05","2021-03-30","2021-03-30","2020-09-15","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2020-05-07","2021-05-18","2021-09-21","2021-08-02","2021-08-02","2021-08-02"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00527293341","PREDNISONE ","TAB 10MG","180","Select","Select",""],["","00069047103","CHANTIX ","PAK 0.5& 1MG","53","Select","Select",""],["","76204020025","ALBUTEROL ","NEB 0.00083","150","Select","Select",""],["","76204010025","IPRATROPIUM ","SOL 0.02%INH","188","Select","Select",""],["","68462010340","FLUCONAZOLE ","TAB 150MG","5","Select","Select",""],["","31722072610","MONTELUKAST ","TAB 10MG","30","Select","Select",""],["","33342002332","LEVOFLOXACIN ","TAB 750MG","14","Select","Select",""],["","66993058597","FLUTIC\/SALME ","AER 250\/50","60","Select","Select",""],["","70377003012","ATORVASTATIN ","TAB 80MG","30","Select","Select",""],["","60758088010","FLUOROMETHOL ","SUS 0.1% OP","10","Select","Select",""],["","08373996900","INNOSPIRE ","MIS NEBULIZE","1","Select","Select",""],["","43598051090","ESOMEPRA ","CAP 40MG DR","90","Select","Select",""],["","13668044201","CELECOXIB ","CAP 200MG","90","Select","Select",""],["","61314063705","PREDNISOLONE ","SUS 1% OP","5","Select","Select",""],["","45802016000","DICLOFENAC ","GEL 0.01","200","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","90","Select","Select",""],["","13668001005","CITALOPRAM ","TAB 20MG","90","Select","Select",""],["","51991074710","DULOXETINE ","CAP 30MG","30","Select","Select",""],["","58160082311","SHINGRIX ","INJ 50\/0.5ML","1","Select","Select",""],["","00005197102","PREVNAR ","INJ ","0","Select","Select",""],["","49281012065","FLUZONE ","INJ PF 20-21","1","Select","Select",""],["","65162062710","TRAMADOL ","TAB 50MG","60","Select","Select",""],["","67877069601","CHLORTHALID ","TAB 25MG","30","Select","Select",""],["","00172392670","DIAZEPAM ","TAB 5MG","1","Select","Select",""],["","58160084252","BOOSTRIX ","INJ ","0","Select","Select",""],["","24208072002","DEXAMETH ","SOL 0.1% OP","5","Select","Select",""],["","00781261305","AMOXICILLIN ","CAP 500MG","21","Select","Select",""],["","00781185220","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","00406048401","APAP\/CODEINE ","TAB 300-30MG","20","Select","Select",""],["","69097081312","GABAPENTIN ","CAP 100MG","90","Select","Select",""],["","00406037601","HYDROCO\/APAP ","TAB 5-300MG","12","Select","Select",""],["","59267100002","PFIZER ","INJ COVID-19","0","Select","Select",""],["","65162046650","IBUPROFEN ","TAB 800MG","30","Select","Select",""],["","61314012605","KETOROLAC ","SOL 0.005","5","Select","Select",""],["","59762444002","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","42571025101","CLINDAMYCIN ","CAP 150MG","21","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":""}]}]}